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6th Annual National Forum on Patient Experience

Drive clinical outcomes, meaningfully partner with your patients, and transform your care.

HQCA is proud to partner with the 6th Annual National Forum on Patient Experience, taking place in Toronto on September 24th-25th, 2018.

PXForum18 is packed with insights and strategies to build your toolkit and address important issues in patient-and-family-centered-care, with 20+ speakers, 10+ patient partners and caregiver speakers, 8 case studies and 10+ hours of networking and discussions. Walk away with actionable strategies to tackle your greatest challenges and revolutionize patient-centered care.

Use a special VIP Code: HQCA20 to get 20% off regular registrations

The Goldilocks philosophy of healthcare administration – What size is “just right”?

Andrew Neuner, Chief Executive Officer, HQCA

Recently, there has been quite a heated discussion in Ontario (more on this here, here, and here) about whether healthcare bureaucracy costs (i.e., costs related to administration; not costs related to delivering front line care) are unreasonable or “bloated”. This conversation is not Ontario-specific and made me think about this in the Alberta context, given we are often criticized for our comparatively high healthcare costs, which includes administration, and see this topic pop up regularly in the news. It is also important to note this is not a 2018 issue. This has been simmering for some time now (see here and here).

Maximizing how we spend public funds on healthcare is critically important. Healthcare is often the largest segment of a provincial/territorial budget, Alberta being no exception to this rule.

As a voter and tax payer myself, I am also personally invested in and care about how our money is being spent.

As a leader of a government agency in healthcare who is both responsible for managing some of that spending within my own organization and recommending ways to improve the quality of healthcare in Alberta (improving quality very often leads to decreased costs), I am truly aware of the weight of this issue and feel a responsibility to champion opportunities to address this every day.

So, before we listen to more pledges about how healthcare spending can and should be reconsidered, especially related to administration, I think there are two important questions to answer:

What do we want our health system to achieve?

What does it take (realistically) to achieve that vision?

As a system, we need to answer these questions and make sure our system is designed to support the desired outcomes.

As health reporter André Picard stated, “Complex systems such as health care don’t run themselves. Oversight and management is required.” Thoughtfully structured bureaucracy supports an efficient and effective healthcare system or, as the famous saying goes, form follows function.

So, before wildly targeting administrative costs, or any other costs within our health system, let’s first consider what we want our health system to achieve (a clearly articulated strategy), followed by important resource mapping to support the realization of that strategy. Or, more simply: Set a goal, then plan and position every part of the system, including administration, in a deliberate and cost-conscious way to support the achievement of that goal. This may require new partnerships and/or innovative approaches and understanding how other health systems outside of Alberta and Canada are achieving the same goals. This could also require asking people to try new roles or challenges. However, answering these questions and then taking actions that focus on outcomes and working to get the vision and structure of our healthcare system “just right” sounds to me like the best way forward.

Follow Andrew on Twitter @HighNeun

HQCA Matters is published monthly and presents HQCA representative perspectives on topics or issues relevant to healthcare in Alberta.

Protecting civility in healthcare

Andrew Neuner, Chief Executive Officer, HQCA

I recently posted a piece about the ideal conditions to pursue improved healthcare quality, which included ‘protecting civility’ as one of those essential conditions.

Civility describes an interaction that is respectful, transparent and inclusive. In the healthcare context, Don Berwick from the Institute for Healthcare Improvement (IHI)said (1), “everything possible begins in civility” and in the absence of civility, dialogue is eroded. He suggests approaching conversations about healthcare improvement as if we are at the dinner table, not in the boxing ring.

Adding further clarity to this dinner table analogy, I read a recent piece (2) that stated, “Fundamental to, and governing the practice of, civility is the principle of reciprocity: your place at my table implies my place at yours.”

This analogy resonates for me and after thinking further on the idea, protecting civility in a discussion or debate about how to improve quality in healthcare in Alberta means:

  • Inviting and welcoming diverse perspectives and opinions to the table,
  • Checking egos at the door,
  • Making sure everyone has an opportunity to speak and to be heard,
  • Creating a safe place for differing opinions to be shared and considered, and
  • Listening with openness and a willingness to reshape perspective or position.

I highly value these five principles when I engage with others, however have to challenge myself to keep them top of mind and apply them consistently. It can be particularly hard when the topic of discussion is one I’m passionate about or consider it an area where I have expertise. I also find it difficult if everyone at the table and especially the “host” does not apply these principles, because it risks making decisions with incomplete information or leaves participants feeling their voices were not heard.

Deliberately engaging in and leading conversations with civility encourages broader expertise and views to be voiced and leadership and followership responsibilities to be shared; creating a flexible or, in some cases, non-existent hierarchy. All of this ultimately fuels innovation and helps a team or system pursue change with more confidence and strength because all perspectives, risks and opportunities have been tabled and considered.

It is also important to clarify that civility benefits all “tables” in healthcare; whether a governance or leadership table, care team huddle, design sprint, project team, etc. Any time people, including those we serve, are brought together to talk about improving how care is delivered is an opportunity to apply these principles.

So, as we continue to protect civility to advance healthcare quality in Alberta, I challenge our health system to:

  • Take a look at your table and invite others you may have overlooked or omitted to pull up a chair;
  • Find opportunities to let your table mates lead, and hone your expertise as follower; and
  • When followers or the most vulnerable among us are brave enough to ask for a seat or opportunity to lead, find a way to say ‘YES’ and make sure their voices are heard.

 

(1) On this page (http://www.ihi.org/resources/Pages/Publications/Era-Three-for-Medicine-Health-Care.aspx), under ‘Related Information,’ there is a link to watch Berwick’s complete keynote speech (recommended). This requires you to register for an Institute for Healthcare Improvement login, which is free.

(2) https://www.newyorker.com/culture/cultural-comment/sarah-huckabee-sanders-and-who-deserves-a-place-at-the-table

Follow Andrew on Twitter @HighNeun

HQCA Matters is published monthly and presents HQCA representative perspectives on topics or issues relevant to healthcare in Alberta.

Introducing FOCUS on Healthcare

FOCUS ON HEALTHCARE

The FOCUS on Healthcare initiative is a new dynamic online reporting tool developed by the Health Quality Council of Alberta (HQCA). Displayed via a website, the tool will allow users to navigate data through user-friendly, interactive charts. Content on the site will be specific to Alberta and include patient experience data, economic data (cost-effectiveness), and health outcome data across a variety of sectors of healthcare.

The FOCUS on Healthcare website is a new and unique way for the HQCA to deliver on its mandate to monitor and report on health service quality and patient safety for Albertans. This work has already started with FOCUS on Emergency Departments, published in January 2017.

FOCUS ON EMERGENCY DEPARTMENTS: DATA UPDATE

On May 25, the HQCA updated its FOCUS on Emergency Departments (ED) website with new data. The time period for the new data is the fourth quarter of the 2016-17 fiscal year (January, February, March). To ensure timely information, we will continue to update the data each quarter.

Visit FOCUS on ED to see the most recent data: www.focus.hqca.ca

FOCUS ON PRIMARY HEALTHCARE: STATUS UPDATE

The HQCA is currently working on primary healthcare as its next sector for the FOCUS on Healthcare initiative.

This spring the HQCA kicked off the project by getting input from patients about their perspectives on primary healthcare. The valuable insights from this full-day patient consultation session provided a starting point for the FOCUS on Primary Healthcare stakeholder advisory committee. Another sub-set of primary healthcare stakeholders are currently participating in this project via a measurement working group, and they will report their recommendations for measures up to the stakeholder advisory committee for discussion.

By December the HQCA will have used the input from patients and stakeholders to finalize its decision on the primary healthcare data it will include on the website, and can begin development of the interactive charts.

Stay tuned for more updates, or contact the HQCA for more information at 1-855-508-8162 or info@hqca-main-branding-nexcess.dev.developmentwebsite.ca.

In pursuit of quality, let’s be more like geese

Andrew Neuner, Chief Executive Officer, HQCA

In reading Dr. Greg Powell’s recent Quality Matters piece; Quality, cost and continuity – A reflection on Falling Through the Cracks: Greg’s Story, I whole-heartedly agree that when we have conversations about improving the quality of healthcare for Albertans, the Alberta Quality Matrix for Health dimensions of quality: acceptability, accessibility, appropriateness, effectiveness, efficiency, and safety should be our compass or ‘North Star’.

Before we forge ahead toward this common destination of quality in healthcare, what conditions create an ideal and trusted space to pursue these dimensions? Here are some of my thoughts.

Take turns leading, placing equal value on leadership and followership.

I have often used the analogy about geese in flight and their relevance to this cooperative relationship between leadership and followership – particularly in a large and complex system like we have in healthcare.

Leadership and followership are complementary skills to appreciate and develop. Knowing when to be a leader or follower, and when to let others lead or follow, allows for more effective and efficient movement together, as a team or system, to maximize collective impact.

Geese fly in a V formation because it:

  • Conserves energy. By staying in formation, they can travel up to 70% further than going off on their own.
  • “Allows them to keep visual contact with one another so they are orientated in the right direction.”

In my experience, the idea of working together to maximize effort and resources is already a shared value in healthcare. However, I think the opportunity here is to become better followers, recognizing when it is time to “let go” and let someone else take the lead position.

With respect to keeping visual contact to maintain formation and correct orientation, geese do this so they are not crashing into each other or getting lost. The parallel in healthcare is the importance of keeping one another informed of respective priorities, plans and activities to reduce the risk of duplicating or pursuing irrelevant work and finding opportunities to share knowledge and/or resources.

Also, geese know it is time to migrate (change) when the weather (conditions, priorities) shifts. And, even though each goose might take a slightly different course or approach when they lead the V, they are all flying to the same destination (clear objective or vision).

By taking cues from our feathered friends, there is an opportunity to be more efficient, increase alignment, and work as a team or system toward the same well-defined goal. I believe that if we can create the right environment by sharing leadership and followership accountabilities, the sky is the limit when it comes to advancing healthcare quality.

There are two other important conditions I think help create that ideal and trusted space to pursue quality improvement and will write about as part of our HQCA Matters series: protecting civility and learning from others. I hope you will stay connected as this conversation continues.

Registration now open for Certificate in Patient Safety & Quality Management Course

Registration is now open for the 2018-19 Certificate in Patient Safety & Quality Management Course. This is an accredited academic course recognized throughout Canada as a highly sought-after certification.

Register now as enrollment is limited!

Who can participate?

Individuals from any organization with a focus on healthcare. The course is designed for healthcare professionals who want to expand their working understanding of concepts in patient safety and quality management and learn from experts in the field.

Participants will:

  • be eligible for continuing education credits
  • be able to distinguish and describe the components of a healthcare safety & quality model
  • be able to describe core principles of patient safety & quality
  • be able to identify key strategies for designing and delivering safer/higher quality healthcare

The course is sponsored by the Health Quality Council of Alberta (HQCA) and the Ward of the 21st Century (W21C). It runs from September 2018 to March 2019 and is offered through the University of Calgary’s Office of Continuing Medical Education & Professional Development.

For more information and to register visit patientsafeycourse.ca.

Quality, cost, and continuity – A reflection on Falling Through the Cracks: Greg’s Story

Dr. Greg Powell, O.C., MD FRCPC

The business of any healthcare system is that of helping people. When people think about their healthcare experience, they reflect on the care they received and what happened to them, or the outcomes of that care; these are the core features of healthcare quality.
Healthcare Quality and Safety Management: A Framework for Alberta, July 2017

Last week, I had the opportunity to attend the premiere of the short film Falling Through the Cracks: Greg’s Story. This film tells the story of a young man, Greg Price, and his journey through the healthcare system that ultimately ended in his unexpected and tragic death.

I have extensive experience with the Canadian healthcare system, both as a patient and provider. My expertise lies in emergency medicine, so I am all too familiar with unexpected and tragic loss. However, Greg’s story is not about a sudden accident. Greg’s story is about getting a diagnosis and treatment, and the gaps in communication along the way that prevented him from receiving timely, quality care. The film does an excellent job of showing us what his care journey felt like and unfortunately, it feels uncomfortably familiar and relatable. Even with limited experience with the healthcare system, it is very easy to see how Greg was able to ‘fall through the cracks’.

Last week’s film screening also included a panel discussion about the implications of this film for Albertans and Alberta’s healthcare system. What an impactful conversation among the panel members and with the audience. I hope that others, like myself, walked out of the theatre thinking perhaps progress is possible if we put our shoulder behind it.

That is the catch, though. What should ‘putting our shoulder behind it’ look like? And, do we have the courage to push?

With respect to the second question, I say yes. There is an increasing appetite for innovation in healthcare in Alberta, making this an opportune environment to put time and energy into this. Also, we are not doing this alone. One of the questions posed by the film audience was, “Is this problem uniquely Albertan?” The answer to this question was simple: No. Making improvements to continuity of care* is a priority for many jurisdictions, across Canada and internationally.

So, we are in this together as we consider, develop, and implement solutions to improve continuity of care. As we do this, we should be considering the foundational work done by the Health Quality Council of Alberta (HQCA) in their 2013 and 2016 reports that identified and then followed up on recommendations on how we can stimulate the greatest improvement in continuity of care for the greatest number of patients. Now, as we engage further in this work and revisit those recommendations, there were three points from the panel discussion worth raising to make sure they stay top of mind and are not sidelined or lost in the hustle bustle of our day-to-day responsibilities.

It’s not about public vs. private

Rather, as stated by one of the health experts on the film discussion panel, “It is about a blend of public and private healthcare that is well-regulated.”

I appreciate that creating this balance and accountability structure would be complicated. However, we (Albertans and Canadians) should feel more urgency to try and simplify the steps to get there and make this goal achievable.

Manage your own healthcare information

Until we have an integrated health system, patients must become partners and advocates to proactively manage their own healthcare. This includes managing healthcare information. Alberta does not have a clinical information system (CIS) that allows providers to access all of our healthcare information. So, patients need to be prepared to ask questions and provide answers to their care team. Additionally, patients can and should feel confident to ask for copies of their healthcare information (e.g. test results) and help to understand that information.

We should focus our conversations and actions less on cost and more on quality

When we sit down to have conversations about how to improve healthcare for Albertans, the Alberta Quality Matrix for Health dimensions of quality: acceptability; accessibility; appropriateness; effectiveness; efficiency; and, safety should be the North Star. This common language for quality was agreed upon by Alberta’s health system leaders more than a decade ago and still resonates.

However, in my experience, current conversations about healthcare quality get derailed by a preoccupation with cost. This opinion was reinforced during the panel discussion at the film screening.

So, it begs repeating until we can reprogram our thinking and reactions to proposed change—

Improving healthcare quality does not equate to increased costs. In fact, just the opposite. Cost savings are actually realized by addressing the six dimensions of quality.

In closing, I strongly encourage you to see this film and consider what you can do, both individually and in your community, to ‘put your shoulder behind it’ and make quality a priority in healthcare.

Dr. Greg Powell, O.C., MD FRCPC, is Vice-Chair of the HQCA Patient and Family Advisory Committee

 

* Continuity of care can be defined as “the degree to which a series of discrete healthcare events is experienced as coherent and connected and consistent with the patient’s medical needs and personal context”. 2013 Continuity of Patient Care Study

2018 Patient Experience Award Recipients Announced

Today the HQCA announced four recipients of its 2018 Patient Experience Award.

We encourage you to read about the recipients here.

As part of this award, the winners will receive funding to participate in a patient experience, quality, or patient safety education event. They will also have the opportunity to share more about their program through a public webcast on June 1, 2018 at 12 p.m. MDT. Details regarding the webcast will be posted to this page closer to the broadcast date and if you would like to receive an alert about this event, please sign up to receive our HQCA news & quarterly newsletter updates.

Please join us in congratulating this year’s 2018 HQCA Patient Experience Award recipients.

Introducing TeamSTEPPS Canada!

The Health Quality Council of Alberta (HQCA) is proud to partner with the Canadian Patient Safety Institute (CPSI) to offer, for the first time in Canada, a foundational course for developing high-functioning teams.

TeamSTEPPS® is an acronym for Team Strategies and Tools to Enhance Performance and Patient Safety. It is a teamwork system developed jointly by the Department of Defense (DoD) and the Agency for Healthcare Research and Quality (AHRQ) to improve institutional collaboration and communication relating to patient safety.

The Canadian Patient Safety Institute is launching TeamSTEPPS Canada™ Regional Training Centres with the Health Quality Council of Alberta as a pilot test site. The Regional Training Centres will develop Canadian TeamSTEPPS Canada™ Master Trainers, who will return to their organizations poised to train others and implement the TeamSTEPPS Canada™ curriculum, tools and resources.

TeamSTEPPS Canada offers participants the knowledge, skills, and tools they need to build and promote sustainable teamwork strategies.

This course is of value to participants from any organization with a focus on healthcare. For more information, visit www.teamstepps-canada.ca

You can also click here to access the registration link for the course on the HQCA website.

HQCA – One of Alberta’s Top Employers for 2018

The HQCA was proud to be selected as one of Alberta’s Top Employers for 2018. We were excited to be given this award that recognizes employers leading their industries in offering exceptional places to work.

The HQCA works to ensure it’s an employer of choice by offering a competitive vacation package, paid time off during the holidays, professional development opportunities, and full health and wellness benefits.

Read the reasons we were selected here.

Alberta’s Top Employers is an editorial competition that recognizes the Alberta-based employers that lead their industries in offering exceptional places to work. Employers are evaluated by the editors at Canada’s Top 100 Employers using the same criteria as the national competition: (1) Physical Workplace; (2) Work Atmosphere & Social; (3) Health, Financial & Family Benefits; (4) Vacation & Time-Off; (5) Employee Communications; (6) Performance Management; (7) Training & Skills Development; and (8) Community Involvement.